Individual
HEATHER WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5979 PARTLOW RD, SPOTSYLVANIA, VA 22551-3070
(540) 582-5142
Mailing address
5979 PARTLOW RD, SPOTSYLVANIA, VA 22551-3070
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2203000692
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220300692
—
VA
Enumeration date
12/26/2017
Last updated
12/26/2017
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